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Topical therapy for vulvar pre-cancer

Topical therapy applies the drug directly onto the cancer. This is another way to treat vulvar intraepithelial neoplasia (VIN), but is not used to treat invasive vulvar cancer.

One choice is to apply the chemotherapy drug, fluorouracil (5-FU), directly to the skin of the vulva. This is called topical chemotherapy. Chemotherapy applied directly to the skin as an ointment will cause local irritation and peeling. This is normal and is part of the local destruction of cancer cells. Medicated ointments suggested by the health care team can help relieve the discomfort of this treatment. Topical chemotherapy for VIN is less effective than laser treatment or surgery.

A second drug that can be used topically is called imiquimod. This drug comes in a cream to be applied to the area of VIN. Imiquimod is not a chemotherapy drug. Instead, it acts by boosting the body's immune response to the area of abnormal tissue. This treatment has improved VIN, and in some women, it has made VIN go away completely.